Before we're faced with a "slash and burn" reduction, what can we do now to right the ship?

"The mean streets of re-engineering" was a banner headline in the mid-to late 1990's in a variety of health care journals. That was after total quality management didn't quite work for many facilities, and before everyone jumped into satisfaction surveys for patients, employees, and medical staffs. As we begin to walk-the-walk for service excellence, we need to be sure that we’re focused on the right services done in the right setting by the right providers with the right outcome. This is not a Chinese menu that you can simply pick and choose from.  It is a required re-focusing of hospital or group practice administration on operations. Now. Daily flash reports, productivity tools and measurements, gain-sharing financial results reporting down to the staff level, transparency in the c-suite, balanced scorecards, public quality reporting, and the list goes on. At a time when potential employees, particularly hard to find licensed professionals, can chose to work for you or not; physicians can provide services in a traditional hospital setting, or create their own ambulatory setting; and payers can select your facility based upon network needs, cost, quality outcomes, you’re correct to be concerned about this question.